Prognostic impact of cholangiocellular and sarcomatous components in combined hepatocellular and cholangiocarcinoma
Prognostic impact of cholangiocellular and sarcomatous components in combined hepatocellular and cholangiocarcinoma
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DOI：
10.1016/j.humpath.2005.08.019
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发表时间：
2006-03-01
期刊：
影响因子：
3.3
通讯作者：
Tsuneyoshi, M
中科院分区：
文献类型：
--
作者：
Aishima, S;Kuroda, Y;Tsuneyoshi, M
肝细胞和胆管细胞癌（cHC-CC）是一种罕见的肝癌类型。P显示肝细胞和胆管细胞成分。胆管细胞癌（CC）在这些肿瘤范围从局灶性到突出。据报道，那些具有肉瘤特征的cHC-CC预后不良。为了阐明CC和肉瘤成分是否影响预后，我们根据肉瘤成分的存在和CC成分的程度将40例cHC-CC患者分为4组。7例（17.5%）肿瘤显示肉瘤成分。其余肿瘤分为低CC组（CC占肿瘤的< 30%，n = 12），中CC组（30%-60%，n = 15）和高CC组（> 60%，n = 6）。高CC组和肉瘤组的血管侵犯比其他组更常见（P = 0.0007）。低、中CC组均无淋巴结转移，高CC组有3例（50%），肉瘤组有2例（29%）（P <0.0001）。肿瘤大小有从低CC组到中CC组再到高CC组增加的趋势。肝细胞癌、CC和肉瘤成分的Ki-67标记指数值为11.4% ± 12.9%。分别为25.4% ± 18.3%和46.0% ± 23.6%。高CC和肉瘤组患者的总体生存率明显低于低CC和中CC组患者（P = 0.0048）。多因素分析总生存率、淋巴结转移。组织学类型、血管侵犯是影响预后的独立因素。具有大CC成分的cHC-CC与具有肉瘤特征的cHC-CC一样具有侵袭性。(c)2006年爱思唯尔公司All rights reserved.
Combined hepatocellular and cholangiocarcinoma (cHC-CC) is a rare type of liver cancer. P displaying both hepatocellular and cholangiocellular components. The cholangiocellular carcinoma (CC) in these tumors ranges from focal to prominent. Those cHC-CCs with sarcomatous features are reported to have a poor prognosis. To clarify whether the CC and sarcomatous component affects the prognosis, we classified 40 patients with cHC-CCs into 4 groups according to the presence of a sarcomatous component and the extent of the CC component. Seven (17.5%) tumors showed areas with a sarcomatous component. The remaining tumors were divided into a low-CC group (CC occupying < 30% of the tumor, n = 12), a middle-CC group (30%-60%, n = 15), and a high-CC group (> 60%, n = 6). Vascular invasion was more frequently present in the high-CC and sarcomatous group than in the other groups (P = .0007). No lymph node metastasis occurred in either the low- or the middle-CC groups, but it was detected in 3 (50%) cases of the high-CC group and in 2 (29%) cases of the sarcomatous group (P < .0001). There was a tendency for tumor size to increase from the low- to the middle- to the high-CC group. The Ki-67 labeling index values for the hepatocellular carcinoma, CC, and sarcomatous components were 11.4% +/- 12.9%. 25.4% +/- 18.3%, and 46.0% +/- 23.6%, respectively. The overall Survival of patients in the high-CC and sarcomatous group was significantly poorer than that of patients in the low- and middle-CC groups (P = .0048). By multivariate analysis of overall survival, lymph node metastasis. histological subgroup, and vascular invasion were significant independent prognostic factors. A cHC-CC with a large CC component is as aggressive as cHC-CC with sarcomatous features. (c) 2006 Elsevier Inc. All rights reserved.